Hello doctors thank you for your help in the past but now I fear I may have had two new exposures. When I went to have my final test for my last exposure I had difficulties drawing my blood. I had to get stuck three different times in one go, none of them results in an amount near sufficient for testing. My fear is that the phlebotomists who stuck me the first two times had to get a second person to come in instead for my third one. At this point I was nauseous and struggling to stay up so I did not see if this second nurse got a new needle or may have picked up an old one thinking the first phlebotomist had it ready for him. How likely is it to get infected from blood draw? My second concern is more due to my memory. I had made it a point to always have protected sex with my boyfriend as neither of us had been recently tested. Even to the point where I got mad at him for trying to go in without protection without my permission once. But there’s one incident where I cannot remember if we used a condom or not despite him claiming I made him use one everytime. He had been tested before his last ex who he had unprotected sex with. She had been in a 6 year relationship prior to him where they were both each other’s “first” thus she never got tested. What would be the likelihood of either of them being infected. I happened to get tested with a duo test 18 days after this sexual exposure and 16 days after the aforementioned blood draw. It is now 23 and 21 days, respectively, after. What tests would you recommend? Would RNA be a good choice at this point? 

Welcome back to the Forum.  As I'm sure you remember, Dr. Handsfield warned you that repeat questions would be deleted without comment.  I have opted to answer because this question is (slightly) different and it will give me an opportunity to provide some final advice regarding HIV and other STIs as well. 

Let me start by congratulating you on your commitment to safe sex.  It will keep you safe.  Having said that, I will now add that it will keep you safe not only from HIV but from other STI.  it appears from my review of this and your past questions that you are inappropriately fearful of getting HIV and may have misconceptions regarding how HIV is acquired.  HIV is acquired, for all practical purposes, ONLY through unprotected, direct sexual contact or injection of infectious material deep into tissue.  It is not transmitted through casual contact, through hand-to-genital transfer of genital secretions, through dental procedures, or through having your blood drawn.  The devices used for drawing blood are designed to only be used a single time and phlebotomists are trained exhaustively to not re-use blood collection materials.  I am not aware of any HIV acquisitions acquired in the U.S. through re-use of blood drawing equipment.  While the fact that your phlebotomists required multiple attempts to draw your blood, this did not put you at risk for HIV.

If you had asked me if you needed testing, I would have emphatically said no. Since you were already tested, I would encourage you to accept your test results as additional proof that you were not infected.  No further testing related to the events you describe is needed. 

Finally, I will add that it appears that you may be in a monogamous relationship.  If so, I fear you are over-testing.  A great way to eliminate concerns regarding not only HIV but also other STIs is for you and your partner to both go get tested at the same time for STIs, including HIV.  If the tests are negative, you are not at risk for infection as long as you remain monogamous.  Condoms add to this protection and also prevent pregnancy.

I hope that this information is helpful.  EWH

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Hello and thank you for replying. I know they wouldn’t PURPOSELY reuse a needle or equipment my concern is that they would’ve been frazzled over the difficult draw and thus would have accidentally picked up a used needle thinking it was new and attempt to draw like that. What would the risk then be with a needle? And my boyfriend and I were in a monogamous relationship but we have since ended things thus he does not see any need to get tested with me for my reassurance. Again the last time he got tested was PRIOR to his ex girlfriend who had unprotected sex with her ex and never got tested. Considering my lapse in memory for a one time occurrence if we used a condom or not, what would be the chance of infection from a one time exposure? I’ve taken a 4th gen test 18 days after (which was actually intended to be my conclusive test for the first exposure I asked about two months ago) what further test would you recommend?

Sorry to hear of your breakup and I apologize for making assumptions.

As for the risk of a phlebotomy mishap, I would still not be worried in the least.  As I said, the equipment is designed specifically to prevent re-use.  Even with your memory lapse, I really would have no concerns at all.  Believe your test results, at the times you describe your results would be reliable, particularly after a no risk event.  IF your ex-BF had HIV (statistically very unlikely- a less than 1.10th or 1% chance unless he has had other males as sex partners) your risk for infection would be less than 1 infection in 1000 exposures.  With your test results, it is zero.

EWH

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Thank you and no need to apology at all but the gesture is appreciated. So the blood draw should be no concern and you would still recommend no further testing on the possible exposure? If we did not use a condom then that means he would’ve ejaculated in me. If this were the case would my 18 day post exposure test really be conclusive even for unprotected vaginal? Or should I take a test at 4 weeks or an RNA right now to be sure? I’ve had no sore throat, fever, or any other “typical” symptoms although I know that doesn’t mean much.  And since this will be last reply I just want to thank you and Dr. Handsfield a lot for what you do. 

As for his sexuality I assume he’s only had sex with women as he identifies as straight and has told me he wouldn’t be interested in sex with a guy and as far as I know he’s only had two exes both women and said he’s only had sex with the one since he last got tested. But I’m not sure since anybody could lie to stay in the closet. Would him having relations with men increase the need for me to test?

These will be final replies.  I understand that you are disconcerted regarding your ex-partner's behaviors (possible unprotected sex, unwillingness to test) but nonetheless this remains a low risk event.  My sincere advice is to put this entire unfortunate incident behind you and to move forward.  I really see no reason for further testing, either related to the issues related to your blood draw difficulties or to your possible unprotected encounter. 

Thanks for your thanks.  In closing, I must remind you that nothing you have described suggests any meaningful risk for HIV.  I trust you will not need to access this site regarding your recent unfortunate events.  I wish you the best.  As per Forum guidelines, this thread will now be closed  Take care.  EWH

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Sorry I know this will likely go unanswered and deleted but on the off chance it’s not to be clear you consider the test I took 18 days after UNPROTECTED sex to be conclusive?

Repetitive  It is conclusive.  Please move on. Further questions may be deleted without comment and without return of your posing fee.  EWH
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